Purpose Burns of the perineum and genital areas are a unique subset of burns, made complex by their damage to specialised tissues and the challenging nature of wound care in this area. Despite their relative rarity, these burns have severe consequences with long-term physical and psychological impacts. There is a paucity of Australian data on these injuries to guide clinicians, particularly in the management of children. This presentation highlights the clinical characteristics and outcomes of perineal and genital burn injuries in children and discusses the key challenges and issues in their multidisciplinary management. Methodology A decade-long retrospective review was conducted on 252 paediatric patients with perineal, genital and buttock (PGB) burns admitted to the Children’s Hospital at Westmead (CHW), New South Wales. Results Most burns occurred as part of more extensive injuries involving the lower limbs, with only 10.7% classified as isolated PGB burns. Adequate first aid was administered in 90.5% of cases, either at the scene or upon hospital admission. Of the 252 patients, 81 required skin grafting, including 42 cases involving the PGB area, and 41.7% required an indwelling urinary catheter (IDC). Complications included urinary tract infections, hypertrophic scarring, and the need for ongoing scar management. Conclusion These findings emphasise the importance of early intervention and specialised care in managing PGB burns in children.